How can I persuade my doctor to let me self test?

[rainey999]

I have been trying to persuade my GP to allow me to self test for my INR (and preferably I would rather self dose). I have been on warfarin for 20 years, following 2 x DVT after an accident.

I would happily pay for the machine and the test strips.

He refuses point blank to consider this - we have previously had disagreements that this particular GP practice, following local HA guidelines, only prescribes in doses of 3mg tablets - you are expected to break them in half and take 2 tablets one day, 2.1/2 on others - my arguement has always been that as this is a dangerous drug that they insist has to be monitored when they say, why can they prescribe inaccurate dosing when tablets to allow more stable dosing are available. (Their arguement is that it stops the elderly getting confused - no mention that is is virtually impossible to break the tablets accurately).

I therefore end up having weekly blood tests - 1/2 a day away from my business every week (they would not allow their staff this time off weekly if they were in my position), because my INR level can either be high or low - depending on whether it was a 2 tablet or 21/2 is tablet day 3 days prior.

I am at a loss - this appears to be the only area that has this regime and they refuse to budge - any suggestions (apart from moving to another area) ???

[armitaged]

I wish I could help you more but am sure that someone else will answer this with more complete suggestions.

I have also been on warfarin for many years, 31 this year, and have been self dosing and monitoring for ten years.

In your position I would buy a monitor and ask your GP to provide the strips, if he doesn't you say that you would buy them yourself, which is what I would do.

I would then self test and record the levels, this could help to remove the problem with the tablet splitting. I would then continue to monitor as the most important element in this is maximising your good health, lifespan and quality of life. I would also attend the clinic as at present until the position is resolved.

Cases like this should be brought to the attention of the Health Secretary as in my laymans' view they are reducing your work output, costing the NHS more and endangering your health, and I am sure that they are not doing your stress levels or Blood Pressure any good!

[greenrob]

I have faced this negativity by the health profession,but after suffering a mini stroke because they got the dose too low and 2 nosebleeds related to too high an INR ,I am determined to fight this.I bought a monitor and still have my tests done at the clinic ,because it is not far away.I have changed clinics twice and am happy with this compromise.The test is easy if you are a practical person and not frail and i assume you are .They should be glad that you are taking the initiative and compare your results with theirs.I still ask the clinic about dosing,but am increasingly working it out for myself.Even if you cant change clinics ,you will feel much better if you know your INR if necessary on a daily basis

[rainey999]

Hi there, many thanks for the replies. I have asked twice and was told categorically no. It is all down the area I live in and the PCT 'guidelines' - it really has got to the point where I will have to move as they are really affecting me and my desire to manage my health. The stupid thing is, I am also type 2 diabetes - fine fro me to check my blood sugar by pricking my finger and using a monitor (not on insulin though) - but if I were on i nsulin - thy would be happy for me to dose myself then - ablsolutely illogical ??

[flowerpower21]

Hello Rainey999, I too have had a few issues relating to self testing... I didn't even know about self testing until I read an article in 'INR Review' magazine that was on the table at my Warfarin clinic... from there it did take me around 2 years to get the XS machine (with the last of my redundancy money)! For me, both my GP and Warfarin clinic are happy with me self testing - the problem they both seem to be up against is the PCT who have stood in the way of allowing my GP to issue the XS test strips on NHS prescription... For me the investment made in purchasing the machine was due to not being able to take time off work because I only get paid for the hours I work - there is no buffer to make up time lost at work from attending a hospital appointment... I am still to this day battling alongside my comrades (GP and Warfarin clinic) to get the test strips on NHS prescription.... I do not self prescribe - but ring my Warfarin clinic with my results and they then advise on what dosage for me to take and they post out the sticky strips for me to place in my patient book. Oh and by the way..... don't be fooled into the option of having the test strips via a private prescription from your GP... the prescription itself will set you back around £15 and then on top of that you will have to pay the £60+ (dependant on what size pack of strips you order) to your Pharmacist/Chemist! I feel that this is something that you will still be battling along with for a few months of so.... I and my comrades (GP and Warfarin Clinic) have been battling with the PCT for 17 months now.... It's not easy and you will feel like you are going in circles... but for me at least my GP is happy with self testing and I haven't got the battle like yourself of GP who doesn't agree with self testing..... I think that because I don't self prescribe my dosage that this is the reason why my GP is happy with self testing.... Keep strong and don't let them grind you down... It does anger me that the NHS is and certain charities are happy to help people who have addictions (drink, drugs etc) and are happy to prescribe them all manner of drugs for which if they would not be taking if they didn't have an addiction... and yet we who are trying to take care of our own health in the most basic way we know how are being crushed from all sides!

[rainey999]

Thank you for all the comments.

I emailed my pct and they have said they have just agreed to patients on warfarin being allowed to self test as long as their clinic agrees they are competent.

Unfortunately, I am currently not under a clinic, my gp practice are the only ones who treat me, so ......... More hoops to jump through, but I will get there!!!!